This new T-32 application, Preventing Prematurity and Poor Pregnancy Outcomes Training Grant, from the Division of Neonatology/Department of Pediatrics at Vanderbilt University School of Medicine is for the establishment of a postdoctoral training program for pediatric subspecialty fellows with a research and career focus in (a) developmental and perinatal biology, (b) genetic, environmental and biochemical/molecular causes of birth defects, preterm birth and its sequelae and (c) improvement in birth outcomes through translational, epidemiological, quality improvement and comparative effectiveness research. The long-term goals of this program are to develop physician-scientists and future leaders in perinatal research who will make career-long contributions that will positively impact birth outcomes. The Specific Aims are to identify promising trainees early in pediatric subspecialty fellowship training and provide them with a robust, interdisciplinary research experience under the supervision of a qualified mentor with ready access to adequate laboratory resources, populations or datasets of mothers and infants at risk of poor birth outcomes. This program will capitalize on the vast institutional resources at Vanderbilt including the Vanderbilt CTSA, a plethora of core facilities, the Masters in Public Health and Masters of Science in Clinical Investigation, the Quality Scholars Program and the Vanderbilt Evidence-based Practice Center. Given the strong applicant pool, we propose to fund two positions per year in each of the 2nd and 3rd years of fellowship training with commitment of institutional funds for continued training in a 4th year when desired. A talented group of NIH-funded investigators with proven track records of successful mentorship have been chosen from across multiple disciplines representing the unique research strengths of Vanderbilt University. The program's structured research training will instill the skills and knowledge required to address critical issues in perinatal health outcomes. Promising junior faculty have been identified as mentors-in-training. A 4 member steering committee and a 6-member advisory committee of intramural and extramural experts in the fields of developmental biology, perinatal health outcomes and physician-scientist training will provide guidance on trainee selection and progress and overall program success.